Provider Information for 1639549157
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Mr. OWEN MICHAEL CAMARCO
Sex: Male
NPI: 1639549157
Last Updated: 2023-08-04
Certification Date: 2023-08-04
Certification Date: 2023-08-04
Details
| Name | Value | ||||||||
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| NPI | 1639549157 | ||||||||
| Enumeration Date | 2015-09-26 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 1563 MISSION ST SAN FRANCISCO, CA 94103-2543 United States Phone: 510-216-4601 | Fax: | ||||||||
| Primary Practice Address | 815 BUENA VISTA AVE W SAN FRANCISCO, CA 94117-4108 United States Phone: 510-936-2710 | Fax: | ||||||||
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